Foizer Guilherme Augusto, Paiva Vagner Cleyton de, Nascimento Rodrigo Domingues do, Gorios Carlos, Cliquet Júnior Alberto, Miranda João Batista de
Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
Ambulatório de Coluna Vertebral, Hospital Geral de Carapicuíba, São Paulo, SP, Brazil.
Rev Bras Ortop (Sao Paulo). 2021 Oct 25;57(2):334-340. doi: 10.1055/s-0041-1735831. eCollection 2022 Apr.
To access the possibility that higher degrees of disc degeneration lead to higher levels of pain and dysfunction. Magnetic resonance imaging (MRI) scans of 85 patients with low back pain lasting for more than 12 weeks were evaluated, and the degree of disc degeneration was quantified according to the Pfirrmann grading system. The Pfirrmann degree in each disc space from L1-L2 to L5-S1, the maximum degree of Pfirrmann (Pfirrmann-max) between the lumbar discs, and the sum of Pfirrmann (Pfirrmann-sum) degrees were correlated (through the Spearman test) with the Oswestry Disability Index (ODI) and the Visual Analogical Scale (VAS) for pain. In total, 87% of the patients had moderate to severe lumbar disc degeneration measured by Pfirrmann-max, and the most degenerated discs were L4-L5 and L5-S1. There was a week to moderate correlation regarding the Pfirrmann-max (r = 0,330; = 0.002) and the Pfirrmann-sum (r = 0,266; = 0,037) and the ODI, and the Pfirrmann scores in L1-L2 were correlated with the ODI and the VAS. Patients with chronic idiopathic low back pain frequently have moderate to severe lumbar disc degeneration, which has a negative impact on the quality of life of the patients. Low degrees of degeneration in L1-L2 might be related with higher degrees of pain and of functional disability.
为探究椎间盘退变程度越高是否会导致更严重的疼痛和功能障碍。对85例持续腰痛超过12周的患者进行了磁共振成像（MRI）扫描，并根据Pfirrmann分级系统对椎间盘退变程度进行量化。从L1-L2至L5-S1每个椎间盘间隙的Pfirrmann程度、腰椎间盘之间的最大Pfirrmann程度（Pfirrmann-max）以及Pfirrmann程度总和（Pfirrmann-sum）与Oswestry功能障碍指数（ODI）和疼痛视觉模拟量表（VAS）进行相关性分析（通过Spearman检验）。 总体而言，根据Pfirrmann-max测量，87%的患者存在中度至重度腰椎间盘退变，退变最严重的椎间盘为L4-L5和L5-S1。Pfirrmann-max（r = 0.330；P = 0.002）和Pfirrmann-sum（r = 0.266；P = 0.037）与ODI之间存在弱至中度相关性，L1-L2节段的Pfirrmann评分与ODI和VAS相关。 慢性特发性腰痛患者常伴有中度至重度腰椎间盘退变，这对患者的生活质量有负面影响。L1-L2节段较低程度的退变可能与更高程度的疼痛和功能障碍有关。
